The practice of physical medicine and rehabilitation in sub-Saharan Africa and Antarctica: A white paper or a black mark?

Introduction. The medical specialty of Physical Medicine and Rehabilitation (PM&R) has had a proven impact on persons with disability and on healthcare systems. Documents such as The White Book on Physical and Rehabilitation Medicine in Europe have been important in defining the scope of practice within various regions. However in some continents the practice has not been well defined. Objective. To explore the practice of PM&R in sub-Saharan Africa and Antarctica. Methods. Medline searches, membership data searches, fax survey of medical schools, Internet searches and interviews with experts. Results. The continents are dissimilar in terms of climate and government. However both Antarctica and sub-Saharan Africa have no PM&R training programs, no professional organisations, no specialty board requirements and no practicing physicians in the field. Since there are no known disabled children in Antarctica and adults are airlifted to world-class health care, the consequences of this deficit are minimal there. However, the 788 000 000 permanent residents of sub-Saharan Africa including approximately 78 million persons with disability are left unserved. Conclusions. Antarctica is doing fine. Africa is in a crisis. Local medical schools, hospitals doctors, and persons with disability; along with foreign volunteers, aid groups and policymakers can impact the crisis. However government - specifically national ministries of health - is ultimately responsible for the health and well-being of citizens.